Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA.
J Gastrointest Surg. 2012 Mar;16(3):581-6. doi: 10.1007/s11605-011-1691-7. Epub 2011 Sep 29.
The aim of this was to define 30-day outcomes of patients treated with colectomy and en bloc pancreatectomy for invasive colon cancer.
ACS NSQIP was used to identify patients who underwent colectomy and pancreatectomy concomitantly (n = 65) for colon carcinoma. Patients with en bloc pancreatectomy were compared to a propensity score-matched control group for 30-day outcomes.
Sixteen patients underwent a pancreaticoduodenectomy with colectomy and 49 patients underwent a distal pancreatectomy with colectomy. There were 195 matched control patients. En bloc pancreatectomy (Whipple vs. distal pancreatectomy vs. control) patients had longer OR times (390 vs. 265 vs.137 min) and length of postoperative stay (12 vs. 10 vs. 6 days). The frequency of pulmonary complications (31.3% vs. 36.7% vs. 3.6%), blood transfusions (2.9 vs. 1.7 vs. 0.3 U), wound dehiscence, (18.8% vs. 6.12% vs.0.5%) and surgical site infection (43.5% vs. 34.7% vs.14.9%) were substantially higher in the pancreatectomy group (p < 0.05). There were no statistically significant differences in 30-day mortality between the pancreatectomy group and the control group (6.3% vs. 0% vs. 1.5% p = 0.25)
Perioperative outcomes with en bloc pancreatectomy and colectomy include increased pulmonary complications, blood transfusions, wound complications, and length of stay compared to patients treated with colectomy alone for colon cancer.
本研究旨在定义接受结肠癌根治性结肠切除术和整块胰切除术治疗的患者的 30 天预后。
使用 ACS NSQIP 识别同时接受结肠切除术和胰切除术（n=65）治疗结肠癌的患者。将整块胰切除术患者与倾向评分匹配的对照组进行 30 天预后比较。
16 例患者行胰十二指肠切除术联合结肠切除术，49 例患者行远端胰腺切除术联合结肠切除术。有 195 例匹配的对照组患者。整块胰切除术（胰十二指肠切除术与远端胰腺切除术与对照组）患者的手术时间（390 分钟与 265 分钟与 137 分钟）和术后住院时间（12 天与 10 天与 6 天）更长。肺部并发症（31.3%与 36.7%与 3.6%）、输血（2.9 与 1.7 与 0.3 U）、伤口裂开（18.8%与 6.12%与 0.5%）和手术部位感染（43.5%与 34.7%与 14.9%）的发生率在胰切除术组明显更高（p<0.05）。胰切除术组和对照组在 30 天死亡率方面无统计学差异（6.3%与 0%与 1.5%，p=0.25）。
与单纯接受结肠癌根治性结肠切除术的患者相比，整块胰切除术和结肠切除术的围手术期结果包括肺部并发症、输血、伤口并发症和住院时间增加。
